右丙亚胺联合参麦注射液在减少急性白血病化疗中心脏毒性的临床研究

摘要

目的：观察比较右丙亚胺注射液单用，参麦注射液单用及右丙亚胺参麦注射液联合使用对急性白血病患者化疗期间心脏毒性的影响。方法将2010年1月-2014年6月该院收治的105例已明确诊断为急性白血病的患者随机分为3组，每组35例。每组患者均应用含有蒽环类药物的化疗方案。A组：右丙亚胺组，在应用蒽环类药物化疗前30 min将右丙亚胺注射液快速静脉滴注。 B组：参麦注射液组，对化疗患者给予参麦注射液保护心脏治疗，用法为50 mg/d静脉滴注。 C组：联合用药组，化疗同时联合应用右丙亚胺及参麦注射液保护心脏。每组药物均在化疗期间使用，化疗结束后停止使用。观察并记录3组患者心肌酶数值变化，心电图改变及左心室射血分数的变化。结果比较3组患者化疗前后的心电图变化，心肌酶变化及左心室射血分数变化，观察其心脏损害的程度及比例。结果表明C组患者各种心脏损害的指标均低于A,B两组。结论右丙亚胺及参麦注射液联合应用对于接受以蒽环类药物为基础的化疗方案的患者，可明显减轻其心脏毒性作用，可作为降低蒽环类药物心脏毒性的新途径。%Objective To observe and compare the single use of dexrazoxane injection, Shenmai injection alone and dexrazoxane Shenmai injection combined with the use of the effect of cardiac toxicity in cancer patients during chemotherapy. Methods 105 cases who had been diagnosed as acute leukemia patients in our hospital from January 2010 to June 2014,were randomly divided into three groups,35 patients in each group. Patients in each group were applied the chemotherapy regimens containing anthracy-clines. Group A:dexrazoxane group.30 minutes before applying anthracycline chemotherapy to dexrazoxane rapid intravenous in-jection. Group B:Shenmai injection group. Given Shenmai injection to protect the heart treatment on patients with chemotherapy, and the usage is the daily intravenous infusion of 50mg.Group C:the combination group. Chemotherapy combined with dexrazoxane and Shenmai injection to protect the heart.Each group of drugs were used during chemotherapy,and after chemotherapy to stop us-ing. Observe and record changes in three groups of patients'cardiac enzyme values, ECG and the left ventricular ejection fraction. Results To Compare the changes about ECG,cardiac enzyme and the left ventricular ejection fraction of the three groups of pa-tients before and after chemotherapy,and observe the heart damage degree and the ratio.The results show that the group C patients with various heart damage index were lower than those of A, B. Conclusion Dexrazoxane combined with Shenmai injection for pa-tients receiving anthracycline-based chemotherapy regimens, can significantly reduce their cardiac toxicity,and be used as a new way to reduce the anthracycline cardiotoxicity.